Healthcare Provider Details

I. General information

NPI: 1518436682
Provider Name (Legal Business Name): MICHELLE HOFFMAN MPH, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2018
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SCHROCK RD STE 505
COLUMBUS OH
43229-1181
US

IV. Provider business mailing address

4244 RANDMORE RD
COLUMBUS OH
43220-4442
US

V. Phone/Fax

Practice location:
  • Phone: 614-643-8024
  • Fax:
Mailing address:
  • Phone: 614-557-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL.D.7919
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: